HomeMy WebLinkAboutKatz, Harry SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1470 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : RANDAZZO BLDG. CO. INC.
Address 1 : 127 SWAN LAKE DRIVE
City St Zip PATCHOGUE NY 11935
Descripton of Proposed Construction or Alteration
SANITARY SYSTEM FOR NEW SINGLE FAMILY DWELLING.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES. SCHD REF. #R10-96-0025
Name Of Owner KATZ, HARRY AND ANA
Mailing Address 1 405 EAST OAKWOOD DRIVE
City St Zip WADING RIVER NY 11792
Property Address 1 LIGHTHOUSE ROAD
City St Zip SOUTHOLD NY 11971
Tax Map No. section 50.00 block 6 lot 5.008
Cross Street SOUND AVENUE
Building Permit Number Cross Reference:
Issue Date: 5/06/96 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
•
i#....
,1��SpFFOu-,O7
0
, j �(
Gy .
JUDITH T.TERRY o fit ; Town Hall, 53095 Main Road
TOWN CLERK y Z P.O. Box 1179
REGISTRAR OF VITAL STATISTICS rn o Southold,New York 11971
MARRIAGE OFFICER �Vao 0. / Fax(516)765-1823
RECORDS MANAGEMENT OFFICER i .( * `1►a��� Telephone(516)765-1800
FREEDOM OF INFORMATION OFFICER . X01.
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: April 29, 1996
Transmitted herewith is a copy of application No. 1530 for a Cesspool/
Septic Tank Construction Permit submitted by:
Randazzo Bldq. Co. Inc. for Harry and Ana Katz
Please review the application and location map and advise if the project
has received Suffolk County Health Department approval and if this office
may issue the permit.
Please complete the form below and return it to me.
Thank you.
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above
and make the following recommendations:
APPROVE
DISAPPROVE
Comments: �' , '-5- 4 �1/c, lJ dca
D� S gnatur-
F., APR 3 O N6 x
Dated
BLDG.DEPT.
TOWN OF SOVTHOLD
•
OFFICE OF THE TOWN CLERK olio
Town of Southold ��°Ie\ ati(e� •
Judith T. Terry, Town Clerk A Application No. I (5-3 :)
Town Hall, 53095 Main Road �� p �'
.' � 4 Construction
P. O. Box 1179 • � ,` • nc �
--: • rn i Alteration
Southold, New York 11971 :152;•
yc �
Telephone 190 ) _go $10.00 - Residential /C
(516) 765-1801 1 1 1� ' $25.00 - Non-Residential
.
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE 2 S
APPLICANT NAME: /` , (IL1 / R z_ c- Q \
APPLICANT ADDRESS: (2;7 -CC/041V b¢e— Air-
y
SEPTIC i/ CESSPOOL t0
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
a W-49
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PRQyPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: C414-/Ry I 14 K/4-T 2—
OWNER
OWNER MAILING ADDRESS: 405— 0/4- ecdcc'1 O/z
,k0,/, if
OWNER PROPERTY ADDRESS: bAf/ S o[ ((rte- . '
�c 4 6�.5r Q�a
SotJAL�( Floc- Soc7T FoL
TELEPHONE NUMBER OF CONTACT PERSON : LF7S`-650-i
TAX MAP NO. : Section 050 Block , Lot c.Fr
CROSS STREET: Sot11•(1p Ai/(
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signature of Appli rN(t
RECEIVED BY : /jj
��-
Town Clerk's Of is
DATE: y` ��9�
N
u' SUFFOLK CO. HEALTH DEPT. APPROVAL
{� H. S. NO.
so • (VACANT) 2 99b
rl, 4 '
COMMON OfZIVE D.
----- ---- — _ -____-0 H 1 S �t Sa
O • .. 2 , O • /, '
Y PROP_ 1000 co.�.5.1-AN ..: _ ,_� ._ ;j CO Q • • •i COUNTY DEPARTMENT OF HEALTH SERVICES
- {:a... I i i
-- , 3 g'♦ x 12 CESSPOOL / P2DP. }. ` l roe
3 w 1-� 5o Z FuT. E xPN. z 1--- -- -- _ - ! +.4, FOR APPROVAL OF CONST'RUCT'ION FOR A
-�., 4 i 4-40USt 1 fl SINGLE FAMILY RESIDENCE ONLY
.4 .c • ___ --I -----. b0" 4_1 ; ,, DAti19'19'x'- _,: ! •�.�. rr ,
Lu LI
fuse ` ,, — ,/ 11'3 N - /'/ APPZOor- ,,--,-
-3
i
- - ' S ~--' D•4 r :,. 'THREE YEARS FROM DATE OF APPROVAL
4---
-,4-1 ' FLYRL J 4 ENVEL yE "` u, -r
O F
0 y
2 •
; - - - 4- r • >T WELL • AEA-8769S. _. .. .._ _ _
-ar SUFFOLK CO. TAX MAP DESIGNATION:
J.
—~ '-rj J -y''E !JL 1 DIST. SECT. BLOCK ��
^ —_ `\rte-1,/
^ t .
'-17:.�C �� ice' 'J�,. Q»..,+. - p'✓�
. i Tax 050 6 f r
' • OWNERS ADDRESS:
'ie.--
r.---49 -- — — --
HO,
— - -- WADI tiG �t L ��ti! y;~�`
t i 929-6 4 2K.) •�4-7.3-0 via(Stu 1
LA , .. U.!
V DEED: L.NA P.
2
L TEST HOLE STAMP
_fl
ii
uI • 0 eliS survey II s Violation a
�� Section 7208 of the Pim Yoke*
P!T/1;1.'17 t�'a1+t}'-�tf'�1 T�Y! 1 r�T -j "criuzation Law.
v1 iF t S. ✓ i 1.,:s. ! ! -.Y+1 I .�. _. en of this survey map not booing 1
sunveyofs inked Mal of
S .} L'.I EY.G D ' ` i f. i.LOT yI NOS.
Q.E.F Et"i.TIO A MI NBEE 'tO12/..S!U$4015 t O P J - t� 9 seal shat not be aanddM.d
;.....4 A
AR
4-1--,
- A Y�A E f OIZ two :sF Z.ltiR. � . 5a hereon shtl nni2V r, jZs r 125-.FtZOi' 5UFF C 3.;£ RW tAa.; O • r : Ole asunny
'
t emnnerdaf aperleY•tt�
kT. t3I E' tr A'�T 3�3' = A ; D. I ,=ad hereon and
,�-�-
BOUT .} �'} EXCAYATIN INSPECTION REUEOIi� aC n I "..:::.3
3utions paybaa01M1�
t Lwi/' ....-_._.. - t Vern;
SEAL
7717------'-----
no L -7,- t *.MY t ASA KATZ 1ti 4PK v
WATER SUPPLY AND VAG DIS!!b Mit' su " tll . (-)7 '.,.
APR 2 5t T3�M19B5. -. ,r�' �r�*
CONFORM WITH NEW STANDARDS RODERICK VAN TUYL. :C. fl-.
TOWN
BLDG.
F S a LICENSED LAND SURVEYORS • .`` 255,4``',f
GREENPORT NEW YORK �, Arlo e4
e ,. `
UtWyNE t-OST N•1120' .. - _